CCL Home > Newsroom > Speeches
Thank you for your introduction, and for this opportunity to participate in A National Dialogue on Students at Risk. I want to congratulate the organizers for putting together such a wide-ranging and thought-provoking program.
This dialogue has brought together speakers from a broad and varied background: education ministries, school administrations and school boards, non-government organizations, athletic programs and theatre groups. We’ve had the occasion to look at several broad themes, including:
We have had speakers who have talked about the importance of early identification of risk. We have looked at ways to strengthen connections between school and the labour market. And we have looked at risk from the perspective of inner city and urban youth, Aboriginal youth, and youth from immigrant and visible minority communities.
I believe we have achieved a remarkable degree of consensus. Perhaps the most important area of consensus is our shared premise that addressing the needs of children at risk is a key priority in Canada’s learning community. As Dr. Levin reminds us, increased educational attainment is linked to every single important positive life outcome – from keeping a job and earning a better living, to better heath and longer life; from greater tolerance to more civic involvement. When we help students at risk, we help lay the foundation for the fulfillment of the lives of individuals, and we set the framework for the overall quality of life in a more harmonious and equitable society.
Canada has a well-earned reputation for equity in its education attainments. The gap between the best- and worst-performing students in Canada is considerably smaller than in most other countries. But all of us are here today because of our commitment to shrinking that gap still further.
The first point I want to emphasize today is that our efforts to address the needs of students at risk must extend beyond the school. Inevitably, schools and teachers are held accountable for the welfare of students. But as we have seen over the past two days, many of the most important tools in addressing the needs of these students lie beyond the school. There is a corollary to this point: the school itself can become the hub of many of the programs and services that, while beyond the jurisdiction of school boards or education ministries, nevertheless have a profound impact on students at risk.
Communities tend to cluster around schools. Just listen to the heated debates in those communities that are about to lose a school – they feel that their heart is being removed. I believe we should do more to make schools the hub of our communities. By “schools” I mean both the physical infrastructure of bricks and mortar as a place for people to gather, and I also mean schools as a learning centre – a place of ideas and interconnection. The more that schools become the hub of our communities, the more we will be able to build a sense of belonging that crosses the generations, and create a sense of cohesion. One result will be that students at risk will come to see the school as more than simply the focal point of their daily grind. They will see the school as a focal point of many of the things they enjoy in their lives – whether that means sports, clubs, or hanging out with friends in a safe environment.
Of course, as the hub of a community, a school often reflects the values of a community. And when a community is in crisis, a school has the challenge of remaining the bastion of what we value and wish to preserve through bad times as well as good. When a community’s economy has been gutted, as has happened recently in several small cities across Canada, the school is expected to carry on with a stiff upper lip. I suspect that many of the principals and the teachers here at this dialogue have likely had ample experience in trying to address the needs of students at risk, only to find that the numbers of these individuals grow because there is a community at risk.
Today I have been invited to address one of the most promising areas where schools can have a major impact on a community. It is also one of the areas through which the education system can have a profound influence on students at risk. That area is the interface between education and health.
Health itself is a key determinant of academic success. It is hard for a student to concentrate on studies when health issues interfere. The success of school breakfast programs on the classroom performance of under-nourished children is one simple example of how the interface works in this direction. Health status and healthy environments also lead to better learning. If we fail to deal with the health issues faced by students at risk, it is difficult to see how they can succeed academically.
But if health helps determine academic success, the converse is also true: academic success contributes to better health. Studies over the years have repeatedly demonstrated a strong link between level of education and level of health. The higher a person’s education status and ability to learn about health, the better his or her health. And so when we cast our vision broadly at the factors to consider when addressing students at risk, we can see multiple benefits in focusing on the health aspects. Not only do we gain all the societal advantages from helping students complete school, we set up the habits that, hopefully, will lead to a lifetime of healthier living.
I can imagine some of the education professionals among us shaking their heads and saying, “Yes, we agree that health and learning go hand in hand. But what more do you expect us to do? Our resources are already stretched to the breaking point already. We don’t have the time or the personnel to add the responsibility of health promotion.”
But how can we ignore the interaction? Ben Levin reminded us that it does not make sense to think of a child who is good at mathematics but in ill health or badly fed as being an educational success. In the final analysis, we must look at the welfare of the child as a whole, and health is such a critical component.
The bottom line is this: schools and our education system must become strong partners in the health care system. This is hardly a startling premise. But the challenge I am going to offer today is the need for closer coordination among health and education and, perhaps most challenging of all, to manage this coordination on a national basis.
The concept of health promotion in schools is not new. It emerged from international movements that are based on two ideas: healthy children are better able to learn; and schools can directly influence children’s health. One of the early milestones was the first International Conference on Health Promotion, which met in Ottawa in 1986. It presented a charter for Health Promotion that included education among the fundamental conditions and resources for health.
There is a considerable body of research that supports the role of the school in promoting better health. One U.S. study reported that 50 hours of well-delivered health instruction can improve student health behaviours, attitudes and knowledge. Another concluded that almost $14 would be saved in health care costs for every $1 invested in school health education. At this point, I am going to be slightly contrarian with respect to the specifics of students at risk. We share a desire to shrink the gap between the best performing and least performing students. We have occasion to look at students at risk from such a variety of perspectives but in a significant way, we must address the needs of students at risk by casting our nets more widely - by addressing the needs of the entire student population. We have found in health policy that systematic targeting of certain socio-economic groups is not as productive as putting in place policies and practices that apply to all. So it will be for the health relationship with non-completion of school. Is by promoting the health of all children and youth at school that we will improve the results of the most vulnerable and at risk students. In other words this is one major area in which a rising tide will lift all boats.
One of the points I want to emphasize today is that the link between education, health, and students at risk goes far beyond what might be included in a health curriculum. An effective health strategy for students at risk must move beyond the classroom. It must include the corridors, the lunchrooms and the schoolyard. It includes the gym, the teachers’ offices, and the home and school meetings. It must infuse every aspect of a school. We must develop what is known in Europe as health-promoting schools – what we are beginning to promote in Canada as comprehensive school health. I will define this term in a moment, but first, let me give some examples.
Canada can point to some excellent practices. Here in British Columbia, for example, the Directorate of Agencies for School Health has been active for 23 years. It promotes Comprehensive School Health as a practical framework, for students, families, schools and communities to network and create plans to enhance student health and learning.
New Brunswick schools have a new comprehensive nutrition policy to promote the consumption of foods with maximum nutritional value. Many provinces have guidelines and recommendations, but New Brunswick now has clear standards on what are acceptable food choices to offer from kindergarten to Grade 12. The policy removed foods with minimal nutritional value from elementary schools. In secondary schools, foods with minimal nutritional value will be phased out over two years. This applies, as one might expect, to cafeterias, vending machines and canteens. But it also extends to fundraising endeavours organized by schools or students. Does your school band sell chocolate bars to raise money, for example? What kind of signal does that send?
Across Canada, we can point to many successes in developing comprehensive school health, but there is more that we can do – much more. In fact, compared to other countries, Canada has a poor record of enhancing and promoting the health of students in elementary schools. Part of the reason is that, until last year we have never taken a national approach – unlike almost every other developed country. Other federal states, such as Australia, have been much more effective at coordinating and advancing the use of schools to promote health, and the promotion of health to improve academic performance.
The World Health Organization promotes effective school health programs as one of the most cost-effective investments a nation can make to simultaneously improve education and health. The WHO is interested in promoting school health programs as a strategic means to prevent important health risks among youth, and to involve the education sector directly in the kinds of efforts that will bring about change. The focus not just on the education factors, but the social, economic and political conditions that affect risk.
The WHO launched a Global School Health Initiative in 1995. Its goal is to increase the number of schools that can truly be called “Health Promoting Schools” – in other words, a school that is constantly strengthening its capacity as a healthy setting for living, learning and working.
In Scotland, schools have been given a target of becoming a health promoting schools by 2007. This involves a whole-school approach to promoting the physical, social, spiritual, mental and emotional well-being of all pupils and staff. In England, the extended schools movement includes a large initiative for health promotion to which I will come back in a moment.
In the United States, they refer to “coordinated school health” rather than “health-promoting schools”. The National Center for Chronic Disease Prevention and Health Promotion has developed a School Health Index. It enables schools to identify strengths and weaknesses of its health and safety policies and programs. The schools can then develop an action plan for improving student health, which can be incorporated in the School Improvement Plan.
In Canada, rather than use the term “Health-Promoting Schools,” we refer to Comprehensive School Health – or CSH. The Canadian Association for School Health has described four goals for Comprehensive School Health:
The CSH approach integrates four basic mechanisms to achieve these goals:
Let me go over each of these in more detail.
First, instruction is the basic way students receive information about health and wellness, health risks and health issues. CSH instruction includes active health promotion through curriculum, varied material, physical education, and varied learning strategies. The objective in all of this is to develop knowledge, attitudes, skills and behaviours for healthy decision-making. One of the key features of the health promoting model is that it does not wish to overburden the curriculum. That is why instruction is only one of four basic mechanisms to achieve goals in health promotion in schools.
The second mechanism is support services. These are key to early identification and treatment of many problems that can cause long-term learning difficulties if not addressed. These services may include health, social and psychological services. Many of these services are not the responsibility of the school, but as I noted earlier, we can also use the school as a community hub that can serve as an access point. The school infrastructure can be used by public health units, social service organizations and non-governmental health agencies. The end result is to provide such things as health appraisal. I want again to refer to the extended schools model in the UK, which is put in place by the UK school remodeling team. In this instance schools process, there is systematic integration of school based work with community based work covering this spectrum of activities including, health, social services, formal schooling, career counseling and many other aspects of social policy.
The third mechanism is the psycho-social environment. This includes the psychological and social support available within the school and in relation to the home and community. Here again, we are looking at the school as a hub. The support can come informally from friends, peers and teachers, or formally, through school policies, rules, clubs or support groups. Positive health role models, peer support, a positive school climate, family support and appropriate public policy all contribute to a healthy psycho-social environment.
And finally, the fourth mechanism for comprehensive school health is a healthy physical environment – one that is clean and safe – that helps prevent injuries and disease.
Put all of these four mechanisms together and you have an opportunity for students to observe and learn positive health attitudes and behaviours. We want to reinforce health on many levels and in many ways.
As I have noted, these ideas have been around for a long time. They have gained considerable credence, both in Canada and around the world. And we can point to many success stories from many schools or jurisdictions. What we don’t have in Canada, however, is a coordinated plan to promote these kinds of initiatives in a way that assesses what works and what does not, measures results, and shares best practices. We do not have a coordinated national approach – or at least, we haven’t had one, until now.
The days are over when we could start useful programs, but fail to follow up because of lack of data on impact – or simply because attention shifts to other priorities. Decision-makers in health and education must address school health challenges in a coordinated way, through coordinated programs. They then must work together to monitor progress. In the extended schools process in the UK, it has been found that English schools which are health promoting achieve better learning outcomes. Just think about that in relation to alternative investments in reading, in gym, or an extended health promoting schools. Find out which strategies and investments optimize results. In a Canadian context it would interesting and important to determine, as the English have done, the precise differences in learning outcomes which are produced by active health promotion in the school context.
We need to think about school health, and more generally about health and learning, over the long term.
Two years ago [CK] the Council of Ministers of Education approached the health sector to explore the possibility of forming an intergovernmental partnership to address health, social and learning related problems. The result was a Joint Consortium on School Health. It was given a mandate to act as a catalyst to strengthen cooperation among ministries, departments, and others. The mutual goal is to build the capacity of both the health and education systems.
The Joint Consortium has been fostering cooperation among provincial and territorial school health coordinators. It is gathering best practices and publishing the lessons learned. It supports working groups on specific concerns such as nutrition, social behaviours of youth, or vulnerable groups such as Aboriginal students.
Perhaps most importantly, the Joint Consortium is promoting the implementation of specific coordination approaches that have been tested in other countries. These involve coordination of policies across jurisdictions, and both formal and informal mechanisms for cooperation. One of the concepts involves the assignment of staff, known as “coordinators,” to manage actively the integration of health and education initiatives. Among other things, the coordinators would be responsible for measuring the effectiveness of the initiative through ongoing surveys of health and periodic surveys of programs.
The concepts developed by the Joint Consortium are now being investigated by the School Health Research Network. We in the SHRN want to take a broad view of the school context, drawing from systems theory and other ecological approaches to school health research. On our website we provide lists of Canadian researchers and recent studies. We also provide self-assessment tools for schools and public health agencies, and we are looking at the possibility of developing an online School Health Journal.
The review we have conducted on the existing research suggests that comprehensive and holistic approaches to health and learning hold the most promise. Programs should be aimed at the whole child, using the whole school, linked with the home and the community. The program should take a longer-term horizon, stretching over several school years, and include changes to many different aspects of the school, including cafeterias, physical education classes, lunch and recess.
We want to promote longer, controlled and other kinds of studies to test the evidence of the impact that school health programs have on both health and learning. The research linking the lifelong impact of combining health and education is extensive – the intervention between health and learning is expensive, if you want to design the kind of holistic system we have in mind. Yet, we hypothesize that the research would show there are considerable savings over the long term.
At the same time, we recognize that there are limits to how much we can use the schools for the promotion of health. After all, schools are primarily educational, not health, institutions. Moreover, we don’t yet have the experience of coordinating health and learning initiatives over the long term. Usually we are responding to a crisis, or taking advantage of a short-term opportunity when external funding becomes available. We need to build more capacity within the system so that change will come from the bottom up, without the need for external sources of funding.
This is the approach we are taking at the School Health Research Network. In the meantime, we have opened another front in our effort to build a pan-Canadian approach to health and education through the Canadian Council on Learning.
Let me give you a bit of background on the Council, of which I am President and CEO. Some of you may recall that, several years ago, the federal government conducted a nation-wide consultation on innovation. The consultation asked the question, “What does Canada need to succeed in the knowledge economy?” Time and time again, Canadians from all walks of life responded, “a highly educated population.”
The government responded at many different levels. One response was to create CCL as a vehicle to provide a strategic and pan-Canadian perspective on learning. Our organization is built around a model of collaboration, inclusion and partnership. We foster partnerships among learning organizations, community groups, non-government organizations, governments and researchers.
We are still early in our mandate, but I can report that all of our partners in this endeavour share a passion. We are all dedicated to building a pan-Canadian roadmap for learning through the lifespan. And we all want to share what we have learned with our colleagues from around the world, and learn from the best practices of others.
CCL has identified five key areas for learning that require urgent attention. We want to address them from a pan-Canadian perspective, so we have created five regionally-based knowledge centres to support these themes. These centres are responsible for building a national network of experts in each specific learning domain. They will advise the CCL on the priorities for research, knowledge mobilization, and monitoring and reporting, and will promote knowledge exchange. These areas are: Adult Learning, Early Childhood Learning, Work and Learning, Aboriginal Learning, and Health and Learning.
Our Adult Learning Knowledge Centre is located in Atlantic Canada. After all, this region has been very successful in developing a range of literacy and retraining programs that address the challenges adults face. Quebec has invested in learning programs for young children for many years and is home to world-renowned experts in early learning. It should come as no surprise then that our knowledge centre for Early Childhood Learning is located in Quebec. For similar reasons we located our Work and Learning centre in Ontario, and our Aboriginal Learning centre in Manitoba.
I am sure you will understand our reasons for putting our knowledge centre for Health and Learning right here in British Columbia. This province contains a very active base of researchers specializing in the health-education interface. Our knowledge centre here will build on this base and create links among researchers and activists across the country.
We initiated a collaborative process calling for the formation of a consortium for the Health and Learning Knowledge Centre. I am delighted by the high calibre and dedication of the consortium members that have come together under the leadership of Budd Hall at the University of Victoria. The 17-member consortium represents a wide cross-section of researchers, educators and practitioners in the field of health and learning, with expertise across the spectrum from early childhood to senior citizens.
The consortium has an ambitious agenda: to address the full range of determinants of health and learning, including income and social status, literacy and education, social and physical environments, early childhood development, personal health practices, genetics, gender and culture and health promotion. We hope to partner with the Joint Consortium on School Health to improve the tracking of initiatives related to health and learning, develop better data sources and foster knowledge exchange.
Colleagues, I have described what has been happening with the Joint Consortium, the School Health Research Network, and the Canadian Council for Learning. The unifying theme in all of this is that, at last, Canada is beginning to take a pan-Canadian approach to the issue of health and learning.
We have found that there is a high degree of enthusiasm and good will greeting our efforts. Yes, we encounter some people who are interested in protecting jurisdictional turf, but on the whole, there is a recognized need to share resources and best practices. There is a remarkable expression of will to do what needs to be done.
And with that in mind, I hope that we can use this dialogue on Students at risk to create a similar expression of will to bring together the advocates from so many different disciplines to a common purpose.
I invite everyone to set out their thoughts on how we can mobilize nationally – how we can collaborate and coordinate more effectively. It is not enough for us to share our ideas at this dialogue, then go home and carry on as before. We need to emerge with a clear idea on how to sustain and build the momentum we’ve developed here over the past two days.
That is the challenge I offer today. Let’s take a lesson from the way that we have galvanized pan-Canadian action on health and learning. Let’s apply it to a pan-Canadian approach to students at risk. And let us never forget the important role that learning about health can play in helping to diminish risk.
Thank you.
Top